What is ‘Biological Sex,’ really?

One of the dominant narratives in gender theory and queer activism right now is the idea of a separation between “gender” and “sex,” wherein “gender” is a personal identity and gender categories are socially constructed, while sex is “biological.” Interestingly, most writers that use this concept don’t bother to define what, specifically, defines these “natural” and “biological” categories of sex, as though readers should automatically know what they are talking about.

Of course, most readers do automatically know what they are talking about, and therein lies the problem.

I do not contest that there is much value in recent gender discourses. Unraveling and examining the ways in which “gender fables establish and circulate the misnomer of natural facts” (Butler xi) has been an important step forward in discourses around gender. However, such discourses often leave examined the notion of “biological sex.”

Perhaps this has been done as an attempt to placate more conservative minds. To make modern gender politics easier to swallow, by allowing the strict binary of male/female to continue to exist, so long as it remains in the realm of “sex” rather than “gender.” Perhaps not.

Recently, people (both theorists, and activists such as those on tumblr) seem to jump at any chance to “challenge the very basis of feminist thought — that there are 2 sexes and there are 2 genders” (Whittle 198). And yet one must wade through the veritable sea of critiques of the gender binary to find even the smallest suggestion that “sex” is just as socially contrived.

Any modern feminist surely knows that there are more than two genders. But the fact is, “sex” doesn’t fit into a discrete binary, either.

As an ftm trans person, the modern narrative tells me that my gender is man, and my sex is female. Things are certainly more complex than that.

After all, what particular biological fact is it that defines “biological sex?” Is it what chromosomes a person has? Is it their genitals? The level of androgens or estrogens in their blood? Their reproductive organs or capabilities? These are all things biological determinists like to use to define sex, and yet there isn’t a single one of these categories that does not have problematic exceptions.

Genitals can be altered through surgery. Even unaltered genitals do not fall into a simple binary — approximately 1% of births exhibit some form of sexual ambiguity.

There are more sex chromosome possibilities than XX and XY. People are born and can lead full lives with X, XXX, XXY, or XYY chromosomes. Some people born XY but posses “female” primary sex characteristics without medical intervention, and vice versa.

Countless cisgender people with various reproductive health issues exist. Is a cisgender woman not truly a woman if she is born without a uterus?

I am not convinced that there is or should be any one defining biological characteristic that determines “biological sex.” And yet, if one has to be chosen, endocrine sex seems to be the frontrunner. The levels of androgens (eg testosterone) and estrogens in a persons bloodstream affect cellular expression throughout most of the body. And yet even that is problematic — persons with androgen insensitivity syndrome are typically indestinguishable externally from XX cisgender women, but may have blood testosterone levels similar to the average male.

Of course, one can hardly refute the 2-sex binary without mentioning intersex people. Unlike some would like to think, intersex conditions are not all that rare. As mentioned earlier, about 1 in 100 babies is born with some form of intersex condition. As of right now, that estimate means there are more than 3 million intersex people in the United States right now.

Despite this, intersex conditions are still treated as a “medical emergency.” Some have even had their sex “corrected” by doctors without being informed or consenting to the procedure. One such patient states:

[The geneticist] said, “I’m obliged to tell you that certain details of your condition have not been divulged to you, but I cannot tell you what they are because they would upset you too much.” So she’s telling us we don’t know everything, but she can’t tell is what it is because it’s too horrible. (Ferber et al 30).

Doctors have to tell patients terrible things every day. Patients with terminal illnesses such as cancer and ALS, or debilitating conditions like early-onset Alzheimer’s, are all told the explicit details of their condition. They are not told that the news would “upset them too much.” Yet intersex people — many, if not most, of whom have conditions with no significant impact on overall health or lifespan, cannot know the details of their own body?

In many cases, babies born intersex with ambiguous genitalia are “corrected,” — that is, assigned a sex and surgically altered to meet societies standards for that sex — during infancy without the child’s consent. In most of these cases, the “ambiguous” genitalia of the child poses little to no health risk.

These practices are unnecessary, outdated, and morally abhorrent. Feminists have been rallying for years to end female genital mutilation/female circumcision in foreign countries. There is a newer movement to end male circumcision as well, precisely because it is necessary and done without consent. Where is the outrage over this? Intersex infants don’t deserve non consensual genital surgery any more than male or female infants. Are we, as a society, really willing to let surgeons perform unecessary surgeries — which are often painful and can have lasting complications — on our infants, just so that we can pretend there are two discrete sexes?


Abby L. Ferber, Kimberly Holcomb, and Tre Wentling, Sex, Gender, and Sexuality, The New Basics.

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